THE ROLE OF MRI-CSF FLOWMETRY IN THE EVALUATION OF POST ENDOSCOPIC THIRD VENTRICULOSTOMY.

Document Type : Preliminary preprint short reports of original research

Authors

1 Department of Radiodiagnosis and Intervention1, Faculty of Medicine, Alexandria University

2 Department of Radiodiagnosis and Intervention1,, Faculty of Medicine, Alexandria University

3 Department of Neurosurgery Faculty of Medicine, University of Alexandria

4 Department of Radiodiagnosis and Intervention , Faculty of Medicine, Alexandria University

Abstract

1. Introduction The intracranial volume is made up by the CSF volume, the blood volume and the brain parenchyma. The inflow of blood to the skull in systole temporarily increases the intracranial volume. According to the Monroe-Kellie doctrine an increase in one volume should cause a decrease in one or both of the remaining two volumes in order to maintain constant volume. The imbalances that occur in this process of cerebral homeostasis have been linked to different pathologies.

Endoscopic third ventriculostomy is used as an aqueductal bypass procedure for the treatment of obstructive hydrocephalus. Early indications for ETV included hydrocephalus due to congenital and acquired aqueduct stenosis secondary to brainstem and tectal tumors. Today, many patients with hydrocephalus may be considered candidates for ETV.

The cine sequences of phase contrast MRI with cardiac synchronism allow quantifying the CSF flow during a cardiac cycle.

The PC technique provides data about CSF flow velocity and direction during a single cardiac cycle. Not only quantitative velocity information is available, but the image format provides a visual display of the velocity distributions.

The Cine PC-MR technique to confirm CSF flow has been regarded as a standard method for evaluating the patency of a third ventriculostomy. Patency on cine PC- MR Images correlates well with clinical prognosis.

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